EXECUTIVE SUMMARY: A PATIENT-CENTERED GUIDE

TO IMPLEMENTING LANGUAGE ACCESS SERVICES IN HEALTHCARE ORGANIZATIONS

SUBMITTED TO: OFFICE OF MINORITY HEALTH

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

DEVELOPMENT OF A DRAFT HEALTH CARE LANGUAGE SERVICES IMPLEMENTATION GUIDE

National Standards for Health Care Language Services Contract

CONTRACT NO. 282980029, TASK ORDER NO. 48 PROJECT OFFICER: GUADALUPE PACHECO

SUBMITTED BY: AMERICAN INSTITUTES FOR RESEARCH

FINAL DRAFT SEPTEMBER 2005

Executive Summary: A Patient-Centered Guide to Implementing LAS in Healthcare Organizations

Acknowledgments

This guide was developed for the Office of Minority Health (OMH), U.S. Department of Health and Human Services (DHHS) by the American Institutes for Research (AIR) under Contract No. 282980029, Task Order No. 48. The development of the guide was based on valuable input from field experts, administrators, providers, and other healthcare professionals, as well as limited English proficient patients. We would like extend our sincere thanks and appreciation to:

Guadalupe Pacheco, Project Officer, OMH, DHHS, for his vision, guidance, and critical input into the development of the guide and for his commitment to ensuring quality health care for limited English proficient individuals

Dr. Garth Graham, Deputy Assistant Secretary for Minority Health, OMH, DHHS, for his ongoing support and commitment to the development of the guide

Our Expert Panel Members (listed below), for their dedication and commitment to language access issues of language minority populations and for helping to ensure that the guide represents the current state of the field through their extensive advice, input, and careful review of the guide

The administrators and field staff who provided ground-level insights into the process of implementing language access services during our site visits to their healthcare organizations

The administrators, providers, and other healthcare professionals with experience implementing language access services who provided valuable feedback on an outline of the guide

The limited English proficient patients who helped us better understand the barriers, enablers, and ways to improve the healthcare experience during focus group discussions

The core project staff, for their outstanding efforts throughout the duration of this project and their dedication to producing a quality product:

Leilani Francisco, AIR, Project Director Maureen Maurer, AIR, Task Leader Ria Eapen, AIR, team member Jennifer Stephens, AIR, Task Leader, Project Manager Kathy Joyce, M. Kathleen Joyce and Associates, team member Christine Whitmore, AIR, Task Leader Michelle Jones, AIR, Task Leader Catherine McIlwain, AIR, team member Jenny Wong, AIR, team member Rita Kirshstein, AIR, Senior Advisor

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Executive Summary: A Patient-Centered Guide to Implementing LAS in Healthcare Organizations

Expert Panel Members Wilma Alvarado-Little, M.A. Program Manager, Center for the Elimination of Minority Health Disparities University of Albany, SUNY Albany, NY

Glenn Flores, M.D., F.A.A.P. Director, Center for the Advancement of Underserved Children, Department of Pediatrics Associate Professor, Medical College of Wisconsin Milwaukee, WI

Elizabeth Jacobs, M.D., M.P.P. Assistant Professor of Medicine Collaborative Research Unit Cook County Hospital and Rush University Medical Center Chicago, IL

Holly E. Jacobson, Ph.D., M.A. Research Assistant Professor, University of North Texas Health Science Center Fort Worth, TX

Disclaimer

Deeana Jang, J.D.

Senior Civil Rights Analyst, Office for Civil Rights

U.S. Department of Health and Human Services Washington, DC

Yolanda Partida, D.P.A. National Program Director, Hablamos Juntos University of Southern California School of Policy, Planning, and Development Los Angeles, CA

Amy Wilson, M.P.P., C.P.H.Q. Associate Director, Division of Standards and Survey Methods, Joint Commission on Accreditation of Healthcare Organizations Oakbrook Terrace, IL

Mara Youdelman, J.D., LL.M. Staff Attorney, National Health Law Program Washington, DC

While the guide contains Web links to third-party sites, OMH is not responsible for the content of any linked sites. OMH provides these links as a convenience and does not endorse the companies or contents of any linked sites. Names, descriptions, and information do not constitute endorsement of a product, service, or site.

The content of this publication does not necessarily reflect the views or policies of the U.S. Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

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Executive Summary: A Patient-Centered Guide to Implementing LAS in Healthcare Organizations

Contents Introduction ...................................................................................................................................................................1

Importance of Language Access Services ..............................................................................................................1 Access to Care........................................................................................................................................................... 1 Quality of Care.......................................................................................................................................................... 2 Patient Satisfaction.................................................................................................................................................... 2 Resource Utilization.................................................................................................................................................. 2

Background for Language Access Services ...........................................................................................................3 History of the Recommended National Standards for Culturally and Linguistically Appropriate Services

in Health Care ...................................................................................................................................................... 3 Title VI of the Civil Rights Act of 1964.................................................................................................................... 3

State and Local Regulations4 Accrediting Organizations.. 4

What Is the Purpose of the Guide? .........................................................................................................................4 For Whom Is the Guide Designed? ........................................................................................................................5 How Is the Guide Organized? ................................................................................................................................6

Focus on Patient Points of Contact............................................................................................................................ 6 Step 1: Assessing the Language Needs of Your Patients...............................................................................................9

Collecting Patient Data...........................................................................................................................................9 Assessing Patient Needs .......................................................................................................................................10

Step 2: Assessing Your Organizational Capabilities ...................................................................................................10 Promoting Language Access Services at the Organizational Level .....................................................................10 Assessing Your Organizations Capacity for Providing Language Access Services............................................11

Step 3: Planning and Implementing Language Access Services .................................................................................12 Resource Units .....................................................................................................................................................12

Resource Unit A: Interpretation Services......................................................................................................12 Types of Interpretation Services ............................................................................................................................. 12 Developing a Process for Ensuring Competence..................................................................................................... 13 Determining Policies and Procedures for Working With Interpreters ..................................................................... 13

Resource Unit B: Written Materials..............................................................................................................14 Determining a Process for Making Materials Available in Other Languages ......................................................... 14 Types of Services for Written Materials ................................................................................................................. 14 Determining What Materials To Make Available in Other Languages ................................................................... 15 Developing a Process for Ensuring Quality of Written Materials ...................................................................